Permit CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
.PERMIT #: ELC97 -0085
J.. � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 02 / 14 / 97
PARCEL: 2S1O1DC- 03800
SITE ADDRESS-0: 0 SW SANDBURG ST
SUBDIVISION....: ZONING: I -'P
•
BLOCK LOT
Project Description: INSTL 1 SIGNAL CIRCUIT /LIMITED ENERGY PANEL
5O4O/J# 1248
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY • 0 401 - 600 amp • 0 SIGNAL /PANEL • 1
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp ° 0 W /SERVICE OR FEEDER: 0 PER INSPECTION ° 0
201 - 400 amp • 0 1st W/0 SRVC OR FDR.: 0 PER HOUR • 0
401 - 600 amp......: 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 - 1000 amp : 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 ) =4 RES UNITS......... > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR )= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: - -- -- - -- - - - -- FEES -----
MCCORMACK PACIFIC type amount by date recpt
7190 SW SANDBURG ST PRMT $ 40.00 TAT 02/14/97 97- 290410
5PCT $ 2.00 TAT 02/14/97 97- 290410
TIGARD OR 97223 EXPIRED
Phone #:
Contractor:
BACHOFNER ELECTRIC, INC. $ 42.00 TOTAL
55 SE MAIN
REQUIRED I NSPECTIONS
PORTLAND OR 97214 Ceiling Cover Underground Cove
Phone #: 5O3 -233 -2006 Wall Cover Elect' 1 Service
Reg #..: 44569
Kermit is issued subject to the regulations, contained in the _ Ti%(�,(. —e
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm • t t�e� S i gnat ur97
applicable laws. All work will be done in accordance with / I / /
approved plans. This pervit will expire if work is not started � ` within 180 days of issuance, or if work is suspended for ■ore ,(.( :///
than 180 days. I s aed By
- -OWNER INSTALLATION ONLY -
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call for inspection - 639 -4175
I ,
I
Community Development ELECTRICAL PERMIT APPLICATION .
13125 SW Hall BIVd.
Tigard, OR 97223
Planck/Rec. #
Permit # >�L�i7- 1T�R�
ivarrE ►�' 11 Phone (503) 639 -4171
( ) Date Issued �/ 1'
FAX-(503) 6847297
• Issued by
"IT OF TIGARD TDD No. (503) 684 -2772 .
Inspection (503) 639 -4175 s
• 1. Job Address : ,Complete Fee Schedule Below:
•
Name of Development Number of Inspections per permit allowed
Address 7190 SW Sandburg St. Service included: Items Cost(ea) Sum
City/State/Zip Tigard, OR 97223 4a Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) McCormack Pacific h 101al 600 sq• ft. or
portion flrered $25.00 1
Commercial LI Residential 0 , Limited y $35.00
Each Marnal d Home or Modular 2
Dwelling Sonia) or Feeder $88.00
2a. Contractor Installation only: .. 4b. Services or Feeders
Irrctallation, alteration, or relocation 2
Electrical Contractor Bachofner Datacom 200 amps or less $60.00 2
Address 55 SE Main 201 amps to 400 amps $80. 2
Portland State ' OR Zip 97214 40 amps a 600 amps $120.00 2
City amps to 1000 amps $180.00
Phone No. 233 -2006 Over 1C00 erica or volts $340.00 • 2
Contractor's License No. 26-451C Reoonnsd o* $50.00
Contractor's Board Reg. No. 445(39 - 4c. Temporary Services Of Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec' 200 empe or less $50.00 2
License No. 28085 • Phone No. - 201 a� to 400 amps $75.00
I 401 amps to 600 amps $1013.130
Qrer 800 amps to 1000 volts
2b. For owner Installations: see If above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of antics or NNW Ise'• 2
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase al SerViCe or der I°°• 2 Fist 'wench circuit $35.00 n intended for sale, lease or rent. Each adaional branch circuit $5.00
Owner's signature EXPIRF 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section _{if required): Each Imp or irigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a linked energy 2
Please check appropriate item and enter fee in section 5B. p anel, alteration or extension 1 $40.00 40.00
4 or more residential units In one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more •
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
Sa Enter total of above fees $ 40.00
NOTICE 5% Surcharge (.05 X total fees) $ 2.00
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 42.00
Sb .
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ -
COMMENCED. ❑ Trust Account # . $
.42.00
Balance Due $ _
•
•
RECEIVED
FEB 131997
COMMUNITY DEVELOPMENT